Addiction or Substance Use Disorder: Is There a Difference?

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Addiction or Substance Use Disorder: Is There a Difference?

The Diagnostic and Statistical Manual of Mental Disorders (DSM5), has replaced the term “addiction” with “substance use disorder.”  Their experts agree that the term addiction implies negative connotations.  The DSM also includes the terms “substance dependence” and “substance abuse” under the blanket term substance use disorder (SUD).

In addition to the above changes, the DSM does not use the terms abuse or dependence to categorize the severity of the addiction.  SUDs are now classified as mild, moderate, or severe.

How is SUD Diagnosed?

According to the Mayo Clinic:

Drug addiction, also called substance use disorder, is a disease that affects a person’s brain and behavior and leads to an inability to control the use of a legal or illegal drug or medication. Substances such as alcohol, marijuana and nicotine also are considered drugs.

Diagnosing SUD should include a thorough evaluation and assessment by a psychiatrist, licensed substance use counselor, or a psychologist.  Although urine and blood tests can reveal drug use, the tests are not a diagnostic tool.

What Causes Substance Use Disorder?

The simple answer is drugs cause SUD.  However, if SUD was a simple matter, fewer people would be struggling to overcome it.  The answer to what causes substance use disorder is that a number of diverse influences can contribute to a person’s drug or alcohol use.

Those influences can include one, or a combination of, the following:

  • Genetics – having a predetermined vulnerability to substance use.
  • Emotional distress – Issues such as anxiety disorders, depression, ADD, PTSD, or other mental problems can contribute to substance use.
  • Peer pressure – wanting to follow the crowd, have more fun, or be accepted.
  • Environmental factors – drug or alcohol use in the family, financial distress, emotional or physical abuse, and culture can play a role in substance use disorders.
  • Physical health issues – chronic pain and other physical issues can lead a person to use more alcohol or painkillers than they would otherwise.  Increased consumption of these substances can cause dependence and lead to developing SUD.

Studies show that in early adolescence, substance use is influenced more by family and social factors.  However, in young adults the effects of genetics decline as they age.

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How Many SUDs are There Today?

The list of substances that can cause SUD is exhaustive.  However, the DSM-5 breaks it down into 10 classes of addictive substances:

  1. Alcohol
  2. Cannabis
  3. Caffeine
  4. Hallucinogens
  5. Inhalants
  6. Opioids
  7. Sedatives
  8. Hypnotics
  9. Tobacco
  10. Other or unknown substances

Any of the above substances, when ingested in sufficient quantities, will activate a person’s reward system to produce feelings of pleasure or euphoria.  With repeated use of these substances, dopamine levels in the brain decrease.  The brain then sends signals to the body that compel a person to seek more of the substance.

Criteria that indicate substance use disorder can include:

  • Spending more time using, recovering from the effects, and seeking more of the substance.
  • Inability to abstain despite adverse consequences.
  • Unable to control the drug use or control the amount consumed.
  • The substance becomes the person’s main focus.
  • Intense cravings and urges to use more of the substance.
  • Continued use despite knowledge about the physical or psychological issues that can become worse due to the drug use.
  • Finding that it takes more of the substance to get the desired effects.
  • Uncomfortable withdrawal symptoms when the substance is withheld.

The presence of two or three of these symptoms indicates a mild SUD.  Four or five symptoms indicate moderate SUD, and six or more indicate severe SUD.

Reducing the Stigma Surrounding Substance Use

Changing some of the terms we use when talking about addiction can help reduce the stigma that persists today.  For instance, the terms abuse or addiction are associated with negative judgment.  Instead, we should use the term misuse rather than abuse, and substitute substance use disorder for addiction.

Other examples of terms that can reduce stigma include substituting the phrase “someone with alcohol use disorder (AUD)” in place of alcoholic.  Also, we can replace the terms druggie, addict, or junkie with the phrase “a person with opioid use disorder (OUD).”

By changing the words we use when referring to addiction, we can avoid stigmatizing the individual as being the problem.

A Forever Recovery Wants to Help You Defeat SUD

If you or a loved one is struggling with substance use disorder, please contact us at A Forever Recovery today.  We understand the importance of treating you with compassion and respect during your time in our programOur goal is to help you overcome SUD and to enjoy the sober lifestyle that you and your family deserve.

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